Effect of bone grafts on stability of maxillary expansion in cleft palate patients: review of the literature.

Bone grafting of maxillary cleft patients is a procedure that is very commonly done after expansion of the maxilla. Some practitioners assume that after expansion, grafting of the cleft area with bone will maintain arch form and allow long-term retention of the maxillary expansion. Other practitioners believe that physical retention, either short or long-term, is necessary to maintain the maxillary expansion. Still others believe that no matter what procedures are done and what type of retention is used, maxillary expansion of cleft sites is doomed for relapse. A thorough and critical review of the literature reveals the inadequacy of past studies with the resulting conclusion that a well-controlled study is necessary to ask this important clinical question.